{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LENA COWAN","gend":1,"add":"814 BOLD ST","city":"PORTSMOUTH","state":"VA","zip":"23701-9998","dob":"1956-04-26","age":"","mstatus":"","insh":"20025859*01","cliId":"","pno":7572982148,"cno":7572982148,"email":"","ename":"","eno":"","pphy":"TAYLOR, ANDREA NP","ppno":7577381600,"pcpadd":"2613 TAYLOR RD STE 201,","pcpcity":"CHESAPEAKE","pcpstate":"VA","pcpzip":"23321-9998","pcpcounty":"","pcpid":"","pcpname":"Bon Secours Western Branch Primary Care","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7574658616,"pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R59.1","R22.1","C77.0","C82.08","C80.1","Z51.11","C34.11","Z85.89","Z85.72","F17.210","D64.9","Z93.1","C10.9","I10.","K21.9","R13.12","E87.6","C77.4","E43.","Z68.27","E78.2","J98.8","E55.9","Z78.0","Z68.24","S61.250A","L08.9","R13.10","Z45.2","D63.8","Z43.1","R94.8","J43.2","K94.23","J45.909","E78.5","Z86.2","Z86.73","Z79.51","Z79.899","D50.9","I69.344","J42.","C77.9","I73.9","Z85.818","Z88.2","Z98.890","Z87.891","F12.90","R90.82","B19.10","R91.1","R59.0","B18.1","I63.9","Z01.810","J45.20","Z13.1","Z72.0","Z23.","Z13.29","C85.90","C77.1","K59.00","R10.9","Z03.89","C34.90","Z51.12"],"date":["2023-02-23","2021-04-19","2023-09-12","2023-08-29","2021-09-01","2023-07-11","2023-09-12","2023-07-10","2022-11-01","2023-07-10","2022-09-21","2021-12-06","2021-09-21","2023-04-28","2023-04-28","2021-09-02","2023-07-24","2021-09-21","2021-09-21","2021-09-03","2023-04-28","2021-12-14","2023-04-28","2021-12-14","2021-12-14","2022-08-09","2022-08-09","2021-12-06","2023-06-21","2021-09-21","2021-12-06","2023-02-23","2023-02-23","2021-09-15","2022-09-21","2023-02-27","2021-09-15","2022-09-21","2022-09-21","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2022-09-21","2022-09-21","2022-09-21","2022-09-21","2022-09-21","2023-01-12","2023-08-29","2022-09-21","2023-05-26","2021-06-07","2023-02-27","2021-04-14","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2023-05-26","2023-07-10","2023-07-24","2023-07-24","2023-07-25","2023-06-21","2023-09-12"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","43598049501","NAPROXEN SOD","TAB 550MG","60","Select","Select",""],["","43386048024","ORPHENADRINE","TAB 100MG ER","30","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","30","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","3","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","25","Select","Select",""],["","66993068030","OLANZAPINE","TAB 2.5MG","32","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","40","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","00781261305","AMOXICILLIN","500 MG","21","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","68645056354","IBUPROFEN","800 MG","30","Select","Select",""],["","0","COMPOUND"," ","480","Select","Select",""],["","31722070190","LOSARTAN POT","TAB 50MG","30","Select","Select",""],["","42571016242","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","60","Select","Select",""],["","13107000130","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","16729044310","BUPROPN HCL","TAB 150MG XL","90","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","7","Select","Select",""],["","80681013100","VITAMIN D3","CAP 5000UNIT","30","Select","Select",""],["","80681013100","VITAMIN D","3 125 MCG","30","Select","Select",""],["","16729044416","BUPROPION XL","300 MG","90","Select","Select",""],["","00228282011","HYDROCHLOROTHIAZIDE","12.5 MG","90","Select","Select",""],["","68645051554","AMLODIPINE BESYLATE","5 MG","90","Select","Select",""],["","31722070190","LOSARTAN POTASSIUM","50 MG","90","Select","Select",""],["","00173069600","ADVAIR DISKUS","250-50 MCG","60","Select","Select",""],["","00093505998","ATORVASTATIN CALCIUM","20 MG","90","Select","Select",""],["","66993058597","FLUTICASONE-SALMETEROL","250-50 MCG","60","Select","Select",""],["","68645051554","AMLODIPINE TAB","5MG","30","Select","Select",""],["","16729018201","HYDROCHLOROT TAB","12.5MG","30","Select","Select",""],["","00093505998","ATORVASTATIN TAB","20MG","30","Select","Select",""],["","31722070190","LOSARTAN POT TAB","50MG","90","Select","Select",""],["","42571016242","AMOX\/K CLAV TAB","875-125","20","Select","Select",""],["","13107000130","MIRTAZAPINE TAB","7.5MG","90","Select","Select",""],["","16729044310","BUPROPN HCL TAB","150MG XL","90","Select","Select",""],["","66993058597","FLUTIC\/SALME AER","250\/50","60","Select","Select",""],["","69097014260","ALBUTEROL AER HFA","","7","Select","Select",""],["","00173069600","ADVAIR DISKU AER","250\/50","60","Select","Select",""],["","00054418325","DEXAMETHASONE","2 MG","30","Select","Select",""],["","55111015430","ONDANSETRON HCL","8 MG","30","Select","Select",""],["","42858086806","DRONABINOL","5 MG","60","Select","Select",""],["","62332058231","LIDOCAINE-PRILOCAINE","2.5 %-2.5%","30","Select","Select",""],["","24979023103","POTASSIUM CHLORIDE","10 MEQ","10","Select","Select",""],["","66689030516","SUCRALFATE","1 G\/10 ML","414","Select","Select",""],["","00378803093","LANSOPRAZOLE","30 MG","30","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}